1. Getting Started With Your Medical Practicum Experience Winter

2. A FEW PRELIMINARY NOTES ….

3. Influenza Modes of Transmission Respiratory droplet transmission (cough, sneeze) Contact with respiratory secretions and bodily fluids Indirect contact via hand transfer Note: People infected with flu may be able to infect others beginning 1 day before symptoms develop and up to 5-7 days after becoming sick (from Everyday Preventive Actions on CDC website)Everyday Preventive Actions

4. Preventing Influenza Transmission Get influenza vaccination Cover your cough & sneeze Use facemask if patient has droplet precautions Avoid touching your eyes, nose, and mouth Use standard precautions (hand hygiene, gloves) Limit touching of surfaces Disinfect surfaces Keep a distance (if possible) DO NOT go to practicum if remotely feeling sick DO NOT go to practicum until at least 24 hours after you no longer have a fever (without fever-reducing meds) Link to CDC website on seasonal flu

5. MEDICAL PRACTICUM

6. What is the purpose of Medical Practicum? Familiarize yourself with a medical setting Acquire basic competencies in certain areas of medical speech-language pathology – Medical chart review – Patient interviewing and case history – Oral-facial examination – Cognitive, speech, language screening – Swallowing screening and feeding precautions

7. What is a SNF? Skilled Nursing Facility - An institution where round the clock care is provided to individuals by trained nurses (LPNs and RNs). Patients come for long term care and for short term care/rehab (to get better and return home or to a lesser level of care) Some patients come and are still very ill or injured – May have mobility issues, new incisions, IV’s, drains, are in traction, have bruises, are very weak or difficult to arouse

8. What Types of Patients Do SLPs See? Age range of patients in long-term care – 60-69 years: 12% – 70-79 years: 23% – 80 years and older: 57% Top SLP diagnoses in SNF’s – Swallowing: 67% – Cognitive-Communicative Disorder: 47% – Aphasia: 6% – Dysarthria: 5% – Voice Disorder: 3% Source: ASHA NOMS: Adults in Healthcare – Skilled Nursing Facility 2012 – http://www.asha.org/content.aspx?id=15831&LangType=1033 http://www.asha.org/content.aspx?id=15831&LangType=1033

9. How To Be Successful In Medical Practicum Be on time, dressed according to clinic standards and eager to learn Meet in the front lobby of Riverpark Complete any readings or preparation requested in advance Be mindful of HIPPA and confidentiality in and out of practicum

10. How To Be Successful In Medical Practicum If you are feeling uncomfortable about a medical situation, talk with your supervisor as soon as it becomes a concern Maintain professionalism with the staff and residents you meet at all times Communicate with the residents you meet at eye level, with a clear voice and smile!

11. Benefits of Medical Practicum Increase familiarity with this population and type of working environment Hands on experience with commonly used tools Ability to see importance of interprofessional environment

12. How to Prepare InfoCDS> Practicum Placements>UO Placements> Medical Practicum Please read, print and review information and materials for Winter term Sign up for time slot via sign up genius Email me directly: elisep@uoregon with any questions or concerns

13. What to Expect First Visit Tour of facility Client history/chart review Practice professional introduction Participate in patient interview and administration of SLUMS

14. Medical Charts Medical Charts contain current information on the patient’s medical status Professionals who interact with the patient document their interaction in the chart – If it’s not in writing, it did not happen! All information in the chart is absolutely confidential!!

15. Anatomy of a Chart Typically you find: – Demographics and General Info – Physician’s Orders – Care Plan Information – Hospital Discharge Information – Nursing Assessments and Notes – Physician’s Notes – Notes from other departments (Social Services, Dietary, Activities, etc) – Rehab Evaluations and Notes

16. Chart Review Purpose - To gather information needed to complete an assessment Current and prior status - Information regarding status prior to the onset or referral is AS important as gathering information on current status. Impact - During the review, think about the impact of the information you gather and answer additional questions you might have

17. Professional Introduction Introduce yourself Make eye contact Speak clearly State your credentials ( show your ID) State your intention or ask permission to interview

18. During Patient Interview Make note of; – Cognitive status – Orientation – Awareness of problem – Hearing status – Expressive Language Word finding challenges?

19. Personal Interview Cont. Comprehension – Follows directions? – Understands Yes/No? – Ability to follow directions Voice – Loudness – Quality